What are reasonable alternatives to invasive angiography for CAV surveillance in patients who are a few years out from cardiac transplant with impaired renal function?
Answer from: at Academic Institution
In our practice, we move to PET-CT on Year 3 if the prior 2 angiograms with IVUS did not show accelerating disease. The issue with CAV is that there is not much to do about it reactively. The best you can do, is switch to an mTORi regimen early and optimize lipids. IVUS is useful for that reason. Be...
We often use cardiac PETs in our post transplant patients after year 5, as long as they have CAV 0 or 1 in the first 5 years. The cardiac PETs must be read differently than a typical cardiac PET but based on the results, we can then talk to the patient if angiography is worth the risk or avoid using...